You have diabetes and you are on insulin treatment. Many people, when they see the words “diabetes” and “insulin” in one sentence, immediately associate them with syringes and needles and the unavoidable need to prick the skin several times a day. Such picture was true until 2015 when a new player entered the market of diabetes medications. The name of it is Afrezza, thanks to which insulin now can be inhaled.

Afrezza is a brand-name prescription medication that was approved by the Food and Drug Administration (FDA) for managing blood sugar levels in adults age 18 and older with type-1 or type-2 diabetes. The drug’s active ingredient is insulin human. Afrezza belongs to a class of medications called fast-acting insulins (mealtime insulin), which means it works quickly to help manage blood sugar spikes after you have a meal.

Although it’s not the first inhaled insulin, Afrezza has succeeded while other versions failed. Currently, it’s the only kind of insulin that people can inhale into their lungs, and it starts lowering blood sugar levels faster than other types of insulin that people inject under the skin using a needle or an insulin pump. – Afrezza starts working within one minute of entering your bloodstream and begins to lower blood sugar levels in just 12-15 minutes from the moment the drug gets into your system. Afrezza leaves the body faster as well – it’s out of the system in about one and a half hour.

Afrezza comes in the form of a dry white powder contained in cartridges that are used with an inhaler device. The cartridges are available in three different capacities – 4 units, 8 units, and 12 units of the medication. The number of units you have to inhale is relevant to the amount of carbs that your meal contained as well as your current blood sugar level, and your level of physical activity.

To determine the right dosage for you, your doctor will consider several factors that include your age, the type and severity of the condition that you intend to treat with Afrezza, and also other medical conditions that you have. In most cases, doctors prefer to begin the treatment from a lower dosage of the medication. Although your doctor will adjust the dosage of the drug later in order to reach the dosage that fits you the most, the doctor will most likely prefer to prescribe the smallest dosage that will give you the satisfactory result.

For a type-1 diabetes patient, the doctor’s decision on the dosage of Afrezza will depend on whether the patient has taken insulin in the past or not. If the patient hasn’t used insulin in the past, the dosage recommended by doctor will be most likely 4 units of Afrezza at the beginning of every meal.

If the patient has taken insulin in the past, the Afrezza dosage will depend on the patient’s usual dosage of mealtime insulin as follows: Use the 4-unit Afrezza cartridge for up to 4 units of mealtime insulin; Use the 8-unitl Afrezza cartridge for 5-8 units of mealtime insulin; Use 12 units of Alfrezza for 9-12 units of mealtime insulin; Use two 8-unit Alfrezza cartridges for 13-16 units of mealtime insulin; Use 20 units of Alfrezza (8-unit and 12-unit cartridges) for 17-20 units of mealtime insulin; And use 24 units of Alfrezza (two 12-unit cartridges) for 21-24 units of mealtime insulin.

Similarly, for type-2 diabetes patients, the dosage of Afrezza will also depend on if they have taken mealtime insulin in the past or not. If a patient has not taken mealtime insulin in the past, they will start taking Afrezza from 4 units at the beginning of each meal. Otherwise, the Afrezza dosage will be correlated to the patient’s usual dosage of mealtime insulin the same way as described above for patients with type-1 diabetes.

If at the beginning of your meal you accidentally forget to take Afrezza, you’ll have a risk of getting a blood glucose levels spike in response to the food you consume. That’s why you have to take the dose of Afrezza as soon as you remember about it. To avoid missing a dose, the easiest and most obvious solution is to set a reminder on your cellphone.

Also, be extra careful not to take a higher than recommended dose of Afrezza, as overdose may lead to serious side effects, including very low blood sugar levels (severe hypoglycemia), which may result in loss of consciousness, coma, or death. Among other overdose symptoms are seizures, confusion, headache, fast heartbeat, slurred speech, blurry vision, shakiness, and dizziness.